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Psychische Begleiterkrankungen bei Krebspatienten in der Viszeralchirurgie

Psychiatric comorbidities in visceral surgery patients with cancer

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Zusammenfassung

Hintergrund

Tumorpatienten mit psychischer Komorbidität leiden unter vermehrten Lebensqualitätseinbußen und haben oft psychoonkologischen Behandlungsbedarf.

Patienten und Methoden

Insgesamt 99 Tumorpatienten in chirurgischer Behandlung wurden mit dem Strukturierten Klinischen Interview zur Diagnostik psychischer Störungen und mit Fragebögen zur Lebensqualität und zur psychischen Belastung (EORTC QLQ-C30, HADS) längsschnittlich untersucht. 31 Ärzte und 41 Pflegekräfte beurteilten den psychoonkologischen Behandlungsbedarf.

Ergebnisse

Psychische Begleiterkrankungen bestanden bei 19% der chirurgischen Patienten, wobei 10% psychoonkologisch unmittelbar behandlungsbedürftig waren. Diese wurden zu 38–60% von den Behandlern erkannt, zu 78% durch die HADS. Noch 6 Monate nach der Operation litten die Patienten mit psychischen Begleiterkrankungen massiv unter Lebensqualitätseinbußen, Angst und Depressivität, während sich Patienten ohne Begleiterkrankungen besser erholten.

Schlussfolgerung

Ein Zehntel der chirurgisch behandelten Krebspatienten leidet unter psychischen Begleiterkrankungen, die von unmittelbarer psychoonkologischer Relevanz sind und zügig identifiziert und fachgerecht behandelt werden sollten.

Abstract

Background

Cancer patients with mental disorders suffer from a decreased quality of life (QoL) and are in need of appropriate treatment.

Methods

A total of 99 cancer patients were interviewed during surgical inpatient treatment with a structured clinical interview for diagnosis of mental disorders (SCID). The QoL and distress were examined prospectively using the validated questionnaires EORTC QLQ-C30 and HADS. Patient psychological well-being and the need for psycho-oncological treatment were assessed by 31 doctors and 41 nurses.

Results

Of the patients 19% were diagnosed with having a mental disorder and in 10% immediate treatment was deemed necessary. This was identified by doctors and nurses in 38–60% and by HADS in 78% of the cases. The QoL of patients with psychiatric comorbidities was diminished 6 months after surgery, while patients without comorbidities recovered significantly better.

Conclusion

Of the visceral surgery cancer patients studied 10% had a relevant mental disorder. To prevent symptoms becoming chronic they should be detected and treated early and efficiently.

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Danksagung

Die Arbeit wurde vom Bundesministerium für Bildung und Forschung gefördert (NBL-3-Förderung; Kennzeichen 01ZZ0106).

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Darmzentrum und Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Park-Krankenhaus, Morawitzstr. 2, 04289, Leipzig, Deutschland

    O. Krauß

  2. Klinik und Poliklinik für Chirurgie II, Visceral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum, Leipzig, Deutschland

    J. Hauss & S. Jonas

  3. Darmzentrum und Klinik für Allgemeine Chirurgie und Viszeralchirurgie, Park-Krankenhaus, Leipzig, Deutschland

    S. Leinung

  4. Darmzentrum und Klinik für Innere Medizin II – Gastroenterologie/Pneumologie, Park-Krankenhaus, Leipzig, Deutschland

    U. Halm

  5. Zentrum für Psychiatrie Südwürttemberg, SINOVA-Klinikenverbund, Schussental-Klinik, Fachkrankenhaus und Rehabilitationsklinik für Internistische Psychosomatik und Psychotherapie, Württemberg, Deutschland

    C. Albani

  6. Abteilung Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig, Deutschland

    S. Singer

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  1. O. Krauß
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  2. J. Hauss
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  3. S. Jonas
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  4. S. Leinung
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  5. U. Halm
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  6. C. Albani
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  7. S. Singer
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Correspondence to O. Krauß.

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Krauß, O., Hauss, J., Jonas, S. et al. Psychische Begleiterkrankungen bei Krebspatienten in der Viszeralchirurgie. Chirurg 82, 263–270 (2011). https://doi.org/10.1007/s00104-011-2075-y

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